Surgical head holder



y 16, 1967 l. M. SHEVICK ETAL 3,319,954

SURGICAL HEAD HOLDER 3 Sheets-Sheet 1 Filed Jan. 21, 1965 BMW M WW /M wa m r v M3 62 May 16, 1967 M. SHEVICK ETAL 3,319,954

SURGICAL HEAD HOLDER Filed Jan. 21, 1965 6 SheetsSheet 2 JVVE/VTOEJ'.1/2 vM/c; M SA/EV/CK file/v55? 6. Mad Jam M 5% :4 E E i11 QrmIQA/Exn y16, 1957 l. M. SHEVICK ETAL 3,319,954

SURGICAL HEAD HOLDER 5 Sheets-Sheet 5 Filed Jan. 21, 1965 United StatesPatent 3,319,954 SURGICAL EAD HOLDER Irving lvl. Shevick, 17653 ilaloraSt., Encino, Calif. 91316, and Ernest C. Wood, Los Angeles, Caiii; saidWood assignor to said Sheviclr Filed Jan. 21, 1965, Ser. No. 426,955 14Claims. (Cl. 269-328) This invention relates to surgical instruments,and particularly to apparatus for securing the patients head for earsurgery. Such head holders must be capable of adjustment so that theposition of the head can be fixed in a precise position most convenientto the surgeon.

One known head holder utilizes a ball type universal joint beneath therest portion thereof, together with a clamp for securing the universaljoint. This known device also uses a strap that extends across thepatients head. There are a number of disadvantages. The center ofgravity of the patients head is elevated relative to the universaljoint. Thus when the joint is unclamped there is a large degree ofinstability, and it is difficult to position the patients head exactly.Furthermore, the pivot point or center of the joint does not correspondto any natural axis of movement of the patients head. The anatomy of thepatient resists such unnatural adjustment. Even if his head is securelyfastened to the head holder to prevent slippage, a substantial torquemay yet be imposed on the ball joint, and unless it is tightened quitesecurely, it will move, with possibly serious consequences if surgery isin progress. If the clamp is secured, the patient may later suffer fromthe muscle strain. Moreover, the patient may later suffer from severepressure imposed by the head strap. The clamp itself, since it must actupon a ball to resist movement in a number of directions, is notreliable.

The primary object of this invention is to provide an improved headholder free of the foregoing disadvantages, and which does not requireany head strap. For this purpose, a head rest is pivotally mounted upona bracket for movement about an axis extending longitudinally of thesubject and passing close to, if not coincident with, the neck joint.The bracket, in turn, is pivotally mounted on a base for movement abouta transverse axis also passing close to, if not coincident with, theneck joint. The base, in turn, is clamped to the operating table.Separate clamps operate between the rest and the bracket and the bracketand the base, and since each part has a simple pivotal movement ratherthan a compound movement, the clamp is entirely reliable. Since the axesof adjustment correspond to the neck axis, no undue strain is imposedupon the subject; adjustments are readily made; the suspension isrelatively stable; and no head strap is required.

In a number of surgical procedures, certain fixtures may be requiredthat must be held in a fixed position relative to the subjects head.Another object of this invention is to provide a fixture of thischaracter as a part of the head rest whereby the position of thepatients head may be adjusted without disturbing the adjustment of thefixture itself.

Another object of this invention is to provide a head holder of thischaracter that can be operated through sterile draping materials.

Another object of this invention is to provide companion fixture partsthat can be conveniently coupled through the sterile draping material.

This invention possesses many other advantages, and has other objectswhich may be made more clearly apparent from a consideration of oneembodiment of the invention. For this purpose, there is shown a form inthe drawings accompanying and forming a part of the presentspecification, and which drawings, unless as otherwise indicated, aretrue scale. This form will now be described in detail, illustrating thegeneral principles of the invention; but it is to be understood thatthis detailed description is not to be taken in a limiting sense, sincethe scope of this invention is best defined by the appended claims.

Referring to the drawings:

FIGURE 1 is a pictorial view of an operating table showing a patientprepared for surgery;

FIG. 2 is an enlarged side elevational view showing a head holderattached to the end of an operating table, a portion of the apparatusand the sterile draping material being shown in section;

FIG. 3 is a top plan view of a head holder;

FIG. 4 is an end elevational view taken along the plane corresponding toline 44 of FIG. 3;

FIG. 5 is a fragmentary top plan view similar to FIG. 3 but illustratingthe intermediate bracket in a different position;

FIG. 6 is a longitudinal view of the apparatus and taken along a planecorresponding to line 66 of FIG. 3;

FIG. 7 is an end elevational view opposite FIG. 4, a portion of theapparatus being broken away, an alternate adjusted position of the headrest being shown in phantom lines; and

FIG. 8 is a transverse sectional view taken along the planecorresponding to line 8- 8 of FIG. 5.

In FIG. 1 a patient is shown prepared for surgery upon an operatingtable 10. Sterile draping material 11 and 12 is provided that exposes inthis instance the ear of the patient for operative procedures.

Beneath the drape 12 (FIG. 2) is a head holder generally designated bythe reference character 13. The head holder 13 includes essentiallythree parts, a head F rest 14, a right angle bracket 15 and a generallyU- shaped base 16. The head rest 14 as shown most clearly in FIGS. 3 and6, comprises a concave or substantially semi-cylindrical part 17 and anend plate 18 from which the part 17 is suspended. The semi-cylindricalpart 17 tapers along opposite side edges 19 and 20 from the wide end atthe end plate 18 to the narrow free end opposite the end plate.

In the present instance the left ear of the patient is to be subjectedto the operative process and accordingly the right side of the patientshead (FIG. 2) rests on the part 17 with the top of his head close to theend plate. Arcuate cushions 21 are provided in the head rest. If thecushions do not sufiiciently immobilize the head, extra padding may beprovided or adhesive tape may join the head to the sides of the rest 14.Of course the patients head could be oriented in other positions in therest 17 with equal ease.

The end plate 18 is mounted upon the bracket 15 for movement about alongitudinal axis 22 (FIGS. 2, 4 and 6) that in this instancecorresponds to the axis of the cylindrical part 17. The distance betweenthe axis 22 and the head contacting surface of the rest 17 is designedto correspond to about half the diameter of an average adult head.

The bracket 15 includes a plate 23 and an upstanding wall 24 secured tothe plate 23 by the aid of an angle 25. The Wall 24 has an aperture 26(FIG. 6) that receives a pivot plate 27 formed rearwardly of the headrest end plate 18 whereby the head rest 14 is supported for angularmovement about the axis 22.

In order to secure the head rest in an adjusted position, a knurled knob28 is provided. The knob 28 has a reduced threaded extension 29cooperable with a correspondingly threaded aperture 30 in the pivotplate 27. The pivot plate 27 has a thickness less than the correspondingdimension of the aperture 26 whereby it is at all times recessed withinthe aperture 26. When the knob 28 is rotated so as to advance in thepivot plate, a thrust Washer 31 is urged to engage the edges of theaperture 26. The washer 31 surrounds the threaded extension 29 and iscaught by the shoulder 32 that forms the extension 29. Thus by rotatingthe knob the parts are firmly clamped together to secure the rest 17 inan adjusted position. As shown in FIG. 8, the engaging surface of thewall 24 about the aperture 26 is provided with radial grooves as at 33for increasing the frictional grip.

The axis 22 of head rest adjustment passes longitudinally through thehead of the subject and falls close to the base of the neck about whichthe head normally swivels. Thus the body of the patient readily moves asthe head rest is adjusted.

The bracket plate 23 (FIG. 6) underlies the head rest part 17 and ispivotally mounted upon the upper plate 34 of the base 15. This upperbase plate 34 rests upon the upper surface of the operating table 10.The pivotal connection is achieved by a rivet 35 or other suitable meansand it determines a vertical axis 35a of swinging movement of the entirehead rest 13. This vertical axis also passes through the neck of thepatient and thus corresponds to one of the points about which the headnormally laterally tilts.

A knurled knob 36 (FIG. 6) serves as a means for clamping the bracketplate 23 against the upper base plate 34, thus to secure any adjustmentof the bracket 14 and head rest 13. The knob 36 has a reduced threadedextension 37 that cooperates with the threaded aperture 38 located inthat upper base plate 34 that projects beyond the head rest. The bracketplate 23 has an arcuate groove 39 (FIG. 3) centered upon the axis 36 sothat the threaded aperture is continuously accessible to the knobextension 37. When the knob 36 is rotated in one direction a thrustwasher 36a clamps the edges on opposite sides of the arcuate groove 39to secure the parts in an adjusted position.

The base 16 includes, in addition to the upper plate 34, a lower plate40 that extends partially along the under surface of the operating table11)., The upper and lower base plates 34 and 40 are connected togetherby a U-bracket 41 that extends across the top end of the table 10. Thesides of the bracket 41 overlie the ends of the plates 34 and 40 and arefastened thereto (FIG. 3) by suitable fasteners 42 and 43. Clamp screws44 and 44a (FIGS. 4, 6 and 7) secure the lower base plate 40 to thetable 10.

The semi-cylindrical part 17 of the head rest extends beneath thelongitudinal axis 22 and accordingly is substantially stable.

The knobs 28 and 36 (FIG. 2) may be manipulated through the drapingmaterial 12 However, since the side edges 19 and 20 taper to encompass aminimum amount of the head, these edges are not so accessible. For thispurpose, a detachable handle extension 45 is provided. The handle 45cooperates with the head rest adjacent the end plate 18. The handle hasa bifurcated end 46 (FIG. 7) that fits over either edge 19 or 20 and itis secured in place by a simple pivoted latch 47. The latch 47 has alatching projection 48 selectively cooperable with aperture 49 or 50 atthe edges 19 and 20 respectively. The latching projection 47 is normallyprojected by a spring thrust member 51 that engages beneath the end ofthe pivoted latch 47 remote from the latching projection 48.

The head rest 14 has provisions for securing a fixture, such asconventional speculum holder 52. For this purpose the head rest has anapertured post 53 (FIGS. 6 and 7) that falls along the inside of the endplate 18. Received in the aperture 54 of the post and beneath thedraping material is a standard 55 (FIG. 2). This standard may be securedin position by a thumb screw 56 (FIG. 7.). The upper end of the post 55has a coupling element 57 in the form of a generally rectangular channelwhereby a sterilized extension 59 of the post can be installed fromabove the draping material. The inner surface of one side wall of thechannel is grooved as at 58. The extension 59 carries a companioncoupling element 60 that fits with substantial clearance in the lowercoupling element 57. By urging the coupling element 60 to the right asviewed in FIG. 2 the parts are secured together so that the extension 59is firmly anchored to the post 55 and thus to the head rest 14. For thispurpose a clamping bar 62 is provided that is located in the channelelement 57. This clamping bar is swivelled on the end of a screw 63 thatprojects through a correspondingly threaded aperture in the oppositeside Wall of the element 57. The screw 63 may be manipulated by a knob64 accessible through the drapery material 12. By rotating the knob 64in opposite directions the parts 66 and 57 are coupled and uncoupled.The rod 59 adjustably mounts a clamp 65. The clamp 65 in turn adjustablyreceives the rod portion 66 of the speculum holder 52. By manipulating aknob 67 the rod 66 is secured to the clamp 65 and the clamp in turn issecured to the post extension 59.

The inventors claim:

1. In a head holder: a base; a bracket; a head rest havinghead-supporting surfaces defining a seat to locate the head of thesubject relative to the head rest with the top of the head at one endregion of the head rest and the neck at the other end region of the headrest; means pivotally mounting the head rest on the bracket for movementabout a first axis fixed with respect to the head rest and the bracket,said axis extending longitudinally of the head rest to passlongitudinally through the head and neck of the subject; and meanspivotally mounting the bracket on the base for movement about a secondaxis fixed with respect to the bracket and the base, said second axisextending transverse to said first axis to extend transversely of theseat as well as transversely through the neck of the subject.

2. The combination as set forth in claim 1 together with: firstreleasable clamp means securing the head rest in an adjusted positionwith respect to the bracket; and second releasable clamp means securingthe bracket in an adjusted position with respect to the base.

3. The combination as set forth in claim 1 together with: means fordetachably securing the base to the end of an operating table.

4. In a head holder: a generally U-shaped base designed to fit over theend of an operating table or the like, and having a part adapted toextend along the top of the table; a bracket resting upon said base partand pivoted thereto for slidable movement along the surface of said basepart about an axis substantially perpendicular to the base part, saidbracket also having a wall extending upwardly from the bracket plate;said bracket plate having an arcuate slot centered on said axis; a firstclamping knob having a threaded extension engaging the base part at aplace spaced from said axis, and extending through said arcuate slot forreleasably clamping said bracket to said base; a head rest having asubstantially semicylindrical rest part having side edges, said headrest having an end plate at one end; said wall having a through annularaperture, the axis of which extends parallel to and above to saidbracket plate in a direction longitudinally of the bracket; said headrest end plate having an annular portion extending into the aperture forpivotal connection therebetween and for angular movement of the headrest about the axis of said aperture; said annular portion locating saidrest part above said bracket plate to clear the bracket plate uponangular movement of the head rest; and a second clamping knob having areduced threaded extension extending through the aperture and engagingsaid head rest end plate to draw said end plate against said bracketwall.

5. In a head holder: a generally U-shaped base de signed to fit over theend of an operating table or the like.

and having a part adapted to extend along the top of the table; abracket resting upon said base part and pivoted thereto for slidablemovement along the surface of said base part about an axis substantiallyperpendicular to the base part, said bracket also having a wallextending upwardly from the bracket plate; said bracket plate having anarcuate slot centered on said axis; a first clamping knob having athreaded extension engaging the base part at a place spaced from saidaxis, and extending through said arcuate slot for releasably clampingsaid bracket to said base; a head rest having a substantiallysemicylindrical rest part having side edges, said head rest having anend plate at one end; said wall having a through annular aperture, theaxis of which extends parallel to and above to said bracket plate in adirection longitudinally of the bracket; said head rest end plate havingan annular portion extending into the aperture for pivotal connectiontherebetween and for angular movement of the head rest about the axis ofsaid aperture; said annular portion locating said rest part above saidbracket plate to clear the bracket plate upon angular movement of thehead rest; a second clamping knob having a reduced threaded extensionextending through the aperture and engaging said head rest end plate todraw said end plate against said bracket Wall; a detachable handleextension having a bifurcated end adapted to fit the side edges of saidhead rest part along said head rest end plate; a latching arm pivotallymounted along the side of said handle and having a latching projectionmovable across said bifurcations; spring means normally operativelypositioning said latching projection; said head rest part havinglatching recesses at both side edges for receiving said latchingprojection.

6. The combination as set forth in claim 1 in which said head rest has asubstantially semicylindrical configuration; and a handle detachablysecured to one of the side edges of the head rest.

7. The combination as set forth in claim 1 together with: a post member;and a clamp member; one of said members being carried at said one endregion of the head rest; one of said members having a socket expansiblefor detachably receiving one end of the post member with substantialclearance and contractible for closing about the post member whereby thepost member may be clamped with draping material interposed between thepost member and said socket.

8. The combination as set forth in claim 1 together with: a two partpost, one of said post parts having a socket at one end expansible fordetachably receiving the end of the other part and contractible forclamping the parts together whereby the parts may be clamped togetherwith draping material lining the socket; and means carried by the headrest for releasably securing one of said post parts.

9. In a head holder: a head rest; means adjustably supporting the headrest; a post member; and a clamp member; one of said members beingcarried at said one end region of the head rest; one of said membershaving a socket expansible for detachably receiving one end of the postmember with substantial clearance and contractible for clamping aboutthe post member whereby the parts may be clamped with draping materialinterposed between the post member and said socket.

10. In a head holder: a head rest; means adjustably supporting the headrest; a post; and means carried by the head rest for securing the postthrough draping material interposed between the post and the head rest,comprising companion coupling elements carried respectively by the postand the head rest, one of said elements being a socket and the other ofsaid elements being a projection the end of which is loosely fitted anddetachably received in the socket whereby draping material can beinterposed between the elements, and a releasable locking device forurging the projection element against one wall of the socket.

11. In a head holder: a head rest: means adjustably supporting the headrest; a post; and means carried by the head rest for securing the postthrough draping material interposed between the post and the head rest,comprising companion coupling elements carried respectively by the postand the head rest, one of said elements being substantially U-shaped,and the other of said elements being a projection the end of which isfitted with substantial clearance in said one element and detachabletherefrom for interposition of draping material between the elements, aclamping bar, a threaded post carrying the bar at one end of the post,said post being threadedly mounted on one side wall of said U-shapedelement for movement of the clamping bar toward and away from the otherside wall of said U-shaped element for clamping the projection againstsaid other side wall, and means for manually rotating the threaded post.

12. In a head holder: a head rest; means adjustably supporting the headrest; a post; and means carried by the head rest for securing the postthrough draping material interposed between the post and the head rest,comprising companion coupling elements carried respectively by the postand the head rest, one of said elements being substantially U-shaped,and the other of said elements being a projection the end of which isfitted with substantial clearance in said one element and detachabletherefrom for interposition of draping material between the elements, aclamping bar, a threaded post carrying the bar at one end of the post,said post being threadedly mounted on one side wall of said U-shapedelement for movement of the clamping bar toward and away from the otherside wall of said U-shaped element for clamping the projection againstsaid other side wall, and means for manually rotating said threadedpost, said elements having ribs substantially interlocking each otherthrough the draping material.

13. In a surgical head holder: a base having means for affixing the baseto one end of an operating table; a bracket; first pivot means confiningthe bracket for movement about a vertical axis fixed with respect to thebase; a head rest having head-supporting surfaces defining a seat tolocate the head of the subject relative to the head rest with the top ofthe head at one end region of the head rest and the neck at the otherend region of the head rest; and second pivot means confining the headrest on the bracket for movement about a substantially horizontal axisfixed with respect to the bracket, and extending longitudinally throughthe said neck region of said head rest and longitudinally through thehead of the subject supported by said head rest, said second pivot meansbeing located to position the said other end region of the head restsubstantially to be intersected by said vertical axis whereby the saidhead rest may be adjusted about said axes with said axes both passingthrough the said neck region of said head rest.

14. The combination as set forth in claim 13 together with: firstreleasable clamp means securing the head rest in an adjusted positionwith respect to the bracket; and second releasable clamp means securingthe bracket in an adjusted position with respect to the base.

References Cited by the Examiner UNITED STATES PATENTS 3,188,079 6/1965Boetcker 269328 RICHARD H. EANES, IR., Primary Examiner.

1. IN A HEAD HOLDER: A BASE; A BRACKET; A HEAD REST HAVINGHEAD-SUPPORTING SURFACES DEFINING A SEAT TO LOCATE THE HEAD OF THESUBJECT RELATIVE TO THE HEAD REST WITH THE TOP OF THE HEAD AT ONE ENDREGION OF THE HEAD REST AND THE NECK AT THE OTHER END REGION OF THE HEADREST; MEANS PIVOTALLY MOUNTING THE HEAD REST ON THE BRACKET FOR MOVEMENTABOUT A FIRST AXIS FIXED WITH RESPECT TO THE HEAD REST AND THE BRACKET,SAID AXIS EXTENDING LONGITUDINALLY OF THE HEAD REST TO PASSLONGITUDINALLY THROUGH THE HEAD AND NECK OF THE SUBJECT; AND MEANSPIVOTALLY MOUNTING THE BRACKET ON THE BASE FOR MOVEMENT ABOUT A SECONDAXIS FIXED WITH RESPECT TO THE BRACKET AND THE BASE, SAID SECOND AXISEXTENDING TRANSVERSE TO SAID FIRST ACIS TO EXTEND TRANSVERSELY OF THESEAT AS WELL AS TRANSVERSELY THROUGH THE NECK OF THE SUBJECT.